US11951024B2 - X-ray markers for scaffolds - Google Patents

X-ray markers for scaffolds Download PDF

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US11951024B2
US11951024B2 US16/475,544 US201816475544A US11951024B2 US 11951024 B2 US11951024 B2 US 11951024B2 US 201816475544 A US201816475544 A US 201816475544A US 11951024 B2 US11951024 B2 US 11951024B2
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region
material layer
ray
predetermined breaking
marker
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US20190336310A1 (en
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Ullrich Bayer
Fabian RISCH
Johannes Riedmueller
Bodo Quint
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Biotronik AG
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Biotronik AG
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    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/82—Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B90/00—Instruments, implements or accessories specially adapted for surgery or diagnosis and not covered by any of the groups A61B1/00 - A61B50/00, e.g. for luxation treatment or for protecting wound edges
    • A61B90/39—Markers, e.g. radio-opaque or breast lesions markers
    • B—PERFORMING OPERATIONS; TRANSPORTING
    • B23—MACHINE TOOLS; METAL-WORKING NOT OTHERWISE PROVIDED FOR
    • B23P—METAL-WORKING NOT OTHERWISE PROVIDED FOR; COMBINED OPERATIONS; UNIVERSAL MACHINE TOOLS
    • B23P15/00—Making specific metal objects by operations not covered by a single other subclass or a group in this subclass
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B90/00—Instruments, implements or accessories specially adapted for surgery or diagnosis and not covered by any of the groups A61B1/00 - A61B50/00, e.g. for luxation treatment or for protecting wound edges
    • A61B90/39—Markers, e.g. radio-opaque or breast lesions markers
    • A61B2090/3966—Radiopaque markers visible in an X-ray image
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2250/00—Special features of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof
    • A61F2250/0058—Additional features; Implant or prostheses properties not otherwise provided for
    • A61F2250/0071—Additional features; Implant or prostheses properties not otherwise provided for breakable or frangible
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2250/00—Special features of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof
    • A61F2250/0058—Additional features; Implant or prostheses properties not otherwise provided for
    • A61F2250/0096—Markers and sensors for detecting a position or changes of a position of an implant, e.g. RF sensors, ultrasound markers
    • A61F2250/0098—Markers and sensors for detecting a position or changes of a position of an implant, e.g. RF sensors, ultrasound markers radio-opaque, e.g. radio-opaque markers

Definitions

  • the invention relates to a method for producing x-ray markers, and also to a medical implant comprising at least one such x-ray marker.
  • An implant of this type can have, for example, a framework (also referred to as a scaffold), in particular a stent framework, which is preferably degradable, i.e. after implantation disintegrates in a defined manner in the body of the patient over a specific period of time.
  • EP 2 457 601 discloses composite markers, which are material combinations of metal marker particles and polymer adhesives.
  • the mass fraction of x-ray-absorbing particles in the composite decisively determines the radiopacity.
  • the fraction of said particles cannot be significantly higher than 90% by weight.
  • the mixture is already so viscous in the uncured state that processing, such as injection into eyelets, is no longer possible.
  • the volume ratios are precisely the opposite of the mass ratios, a further optimisation of this technology is finite.
  • EP 2 399 619 also discloses solid markers sheathed by foreign metals. In this variant the risk of local element formation is considerably reduced, however the technical production effort is high here as well.
  • the object of the present invention lies in providing a method for producing x-ray markers, which method or marker allows an improved handling of the x-ray marker during production.
  • a method is to be provided by means of which x-ray markers can be produced in high quantity with minimal preparative effort.
  • the x-ray marker should preferably also be arrangeable as close as possible to a metal framework, in particular a stent framework, which is hardly radiopaque and in particular is degradable, without any interactions and the associated corrosion effects between the materials on either side.
  • At least one material layer is provided, wherein at least one region of the material layer forming the x-ray marker to be produced is pre-cut such that said region is connected to parts of the material layer surrounding said region (in particular merely) via at least one web extended along an extension direction, which web forms a predetermined breaking point. Due to the connection via a web to the material layer, the x-ray marker is initially prevented from breaking off prematurely from the material layer.
  • the method is proposed so that the at least one predetermined breaking point is arranged in a section of the region (said section being formed in particular by the pre-cutting), such that the at least one predetermined breaking point lies further inward in the extension direction of the web (i.e. is closer to the centre of the region) than two outer edge portions of the region, between which the section lies, and wherein the at least one predetermined breaking point is severed in order to release the x-ray marker from said part of the material layer.
  • the at least one predetermined breaking point is arranged offset inwardly towards the core of the region or x-ray marker.
  • the core by way of example can be the centre of mass of the x-ray marker. Due to the arrangement of the at least one predetermined breaking point further inwardly compared to the other outer edges of the x-ray marker, metal-metal contact between the predetermined breaking point and for example the body of an implant and especially a stent strut is practically ruled out. As a result of this feature, the formation of corrosion-accelerating local elements can therefore be eliminated and ruled out.
  • the x-ray marker can be connected in the material layer to at least one web in the form of a predetermined breaking point.
  • an embodiment with two or more predetermined breaking points provides the advantage of a simpler handling during the process of introducing the marker into the eyelet.
  • two opposing symmetrically arranged predetermined breaking points can thus constitute tapers of the x-ray marker.
  • specially manufactured handling devices can engage in these tapers and can thus ensure a simpler assembly process.
  • These handling devices can be micro-tweezers or micro-tongs, for example.
  • Due to the inward contact face between marker and handling device is also ensured that potential damage to the marker caused by the handling lies at a point that is not critical for contact corrosion.
  • Such a handling in addition, can also be carried out when the inward predetermined breaking points do not lie exactly opposite one another, but are arranged offset from one another at a sufficiently large angle, for example as in the case of three predetermined breaking points distanced by 120°.
  • pre-cutting means in particular that a gap surrounding the region and severing the material layer in part is produced and is interrupted at least by the at least one said web.
  • pre-cutting conveys the idea that the region that will form the x-ray marker, or the x-ray marker itself, is not broken off fully from the material layer, and instead is still connected thereto (via the at least one web with predetermined breaking point).
  • the handling of the individual x-ray marker is improved and protection thereof is facilitated.
  • the mechanical strength of the at least one predetermined breaking point is such that a sufficient transport and storage capability is attained without the marker breaking off prematurely.
  • the herein suggested method facilitates to simultaneous production of hundreds, if not thousands of x-ray markers.
  • an enormous number of x-ray markers can be produces exhibiting the exact same properties due to the simultaneous production.
  • the herein suggested method is efficient and elegant as well in that the above outlined great number of x-ray markers can be disconnected from material layer simultaneously as well rendering the production of such a large number of x-ray markers extremely economical.
  • the at least one material layer in accordance with an embodiment of the invention, is in particular a flat, preferably planar material layer, of which the thickness is preferably significantly smaller than the extent of the material layer perpendicularly to the direction of the thickness of the material layer.
  • the x-ray marker also has a planar form, wherein a thickness of the x-ray marker is preferably likewise significantly smaller than an extent of the x-ray marker/region perpendicular to the direction of thickness.
  • the at least one material layer can be in the form of a tube. Also the tube is supposed to have a thickness significantly smaller than the circumference of the tube.
  • the x-ray marker also has a slightly curved form, wherein a thickness of the x-ray marker is preferably likewise significantly smaller than an extent of the x-ray marker/region perpendicular to the direction of thickness.
  • a thickness of the x-ray marker is preferably likewise significantly smaller than an extent of the x-ray marker/region perpendicular to the direction of thickness.
  • said pre-cutting is performed by means of laser light (here, the laser light or an appropriate laser light beam can, for example, run over the line to be cut or the gap to be cut, or the material layer is moved relative to a fixedly oriented laser beam).
  • laser light here, the laser light or an appropriate laser light beam can, for example, run over the line to be cut or the gap to be cut, or the material layer is moved relative to a fixedly oriented laser beam.
  • Other suitable methods for pre-cutting the x-ray marker/region are water jet cutting or also punching.
  • pre-cutting by means of laser light has the advantage that large quantities can be pre-cut very quickly with high precision.
  • the at least one material layer is a metal foil or a metal foil composite consisting of a number of layers or a tube or tube of a composite material, which in particular is manufactured from one of the following radiopaque materials or comprises one of the following materials: tungsten, tantalum, gold, platinum, iridium, or alloys of the aforementioned materials, such as a platinum-iridium alloy.
  • the web width perpendicularly to the extension direction of the web lies in the range of from 1 ⁇ m to 20 ⁇ m, and preferably in the range of from 2 to 10 ⁇ m, and in particular is 5 ⁇ m.
  • Such a web width is in particular advantageous in respect of a use of the x-ray marker for the visualisation of implants that are the size of vessel supports, since it is possible to prevent the x-ray marker from breaking off prematurely from the material layer during the procedure.
  • This web width also has the advantage that a desired oxidising through the web during the passivation of the x-ray marker can be quickly achieved, whereby the method can be carried out more quickly.
  • a gap running around the region is produced (see also above), which gap preferably has a width ranging from 10 ⁇ m to 100 ⁇ m, preferably ranging from 20 to 60 ⁇ m.
  • the advantage of such a gap lies in the fact that the material layer can be cut through in a reliable manner, whilst the material loss is kept low.
  • said gap is interrupted in accordance with one embodiment merely by the at least one said web.
  • Said extension direction of the web runs in this case in particular perpendicularly to the longitudinal axis.
  • the extension direction of the at least one web can run parallel to the longitudinal axis of the marker.
  • Said edge portions also run on either side of the section or of the web preferably along the longitudinal axis, in particular parallel to the longitudinal axis of the region/x-ray marker.
  • the present proposal also includes the situation in which said edge portions can also be introduced at another point.
  • the region or x-ray marker can have an oval or elongate form with rounded edges. Due to such an areal increase of the dimensions of the region/x-ray marker in the x- and y-direction of the x-ray marker (z corresponds to the thickness direction), it is possible to replace the double marker used in the case of the present scaffolds with an individual marker.
  • the advantage here lies in particular in the omission of the web separating the two individual markers. Approximately 22% x-ray marker surface is gained as a result.
  • the region or the x-ray marker is formed as a continuous layer which does not contain any holes or other cut-outs within the continuous layer. Holes or other forms of cut-outs within the continuous layer would result of course in material loss and thereby in decrease of the x-ray visibility.
  • a solid marker element as described herein also exhibits an improved x-ray visibility in comparison to discontinuous marker materials such as powders or porous materials.
  • the acid has an oxidising effect.
  • the term acid also includes a mixture of a number of acids or also a diluted acid or an acid in an organic solvent.
  • the material attack can be extended to the oxidised boundary layer provided, or (in an oxidising manner) additionally to the substrate there below.
  • the reduction or in the best case scenario removal of the burr has the advantage of minimising the risk that material contact with the scaffold can be produced more easily after the assembly due to protruding parts of the burr.
  • the cut gap is widened and/or said width of the web is reduced (for example from approximately 8 ⁇ m to approximately 3 ⁇ m).
  • the composition of the used acid or acid mixture is dependent in particular on the material of the x-ray marker.
  • an acid mixture consisting of 80 volume % concentrated HNO 3 and 20 volume % concentrated HF can be used.
  • gold a mixture of concentrated hydrochloric acid and concentrated nitric acid in a ratio of 3:1 is used.
  • the same acid mixture is also used in the case of tungsten and platinum, wherein this has to be heated to temperatures between 60 and 80° C. in order to produce material abrasions in the above-mentioned scope within a period from a few minutes to hours.
  • the oxidation is preferably carried out until the web, as predetermined breaking point has, been oxidised through over the entire diameter, such that the web, after the oxidation, consists exclusively of oxidised material and no longer of metal or a metal alloy.
  • the x-ray marker can be captured and filtered off by a suitable means, for example a vessel encased by mesh.
  • the x-ray marker is provided with a fixedly adhering and cohesive passivation layer, which provides an insulation of the x-ray marker with respect to corrosion-accelerating local elements.
  • the corrosion of the web means that the predetermined breaking point is weakened to such an extent that the x-ray marker can be easily broken off from the material layer.
  • the present method by means of a suitable choice of the web width, provides the possibility to carry out the method in a self-regulating manner.
  • self-regulating is understood to mean that the complete oxidation of the web can define a maximum oxidation time.
  • the oxidation period can thus be determined as well by the thickness of the web.
  • the web can be oxidised through and can separate from the material layer at a moment in time when the oxidation layer to be formed has an ideal and advantageous thickness on the x-ray marker.
  • An optimal oxidation thickness layer can thus be regulated by the web width.
  • the predetermined breaking point is severed during or after rinsing processes in distilled water, under the action of a mechanical stimulus, such as ultrasound, and the marker, which is then separated, falls onto the base of the rinsing vessel, from which it can then be easily removed, for example by being filtered off.
  • a mechanical stimulus such as ultrasound
  • Other stimuli can consist in swinging, rinsing out, or rinsing off.
  • the complete or approximately complete oxidation of the at least one web described herein in particular has the advantage that no further mechanical or other steps, such as breaking out or renewed laser cutting, have to be carried out in order to separate the x-ray marker from the material layer. It is also highly advantageous that, by means of the method proposed herein, an x-ray marker which has a uniform, completely cohesive, passivated surface can be provided in an automatic production process. When breaking out or cutting off an x-ray marker from a corresponding material layer, the x-ray marker might have bare metal at the breaking or cutting point on the outer side, and the passivation layer might potentially be provided with scratches, which also expose bare metal.
  • a point with bare metal would have the significant disadvantage that local elements can form much more easily at such a point following application of the x-ray marker to an implant and can promote corrosion of the implant and can significantly reduce the service life of the implant.
  • an x-ray marker is provided which has no such points with bare metal.
  • a uniform x-ray marker of this type can be produced automatically in high numbers during a single process step.
  • M can be Na, K or Li.
  • other anionic mixtures can also be used, such as carbonate, sulphate, or phosphate mixtures, primarily with calcium as cation.
  • This method step is preferably performed at increased temperature in order to achieve a sufficient passivation.
  • the passivation step is performed at temperatures of from 30 to 80° C. and preferably at temperatures ranging from 40 to 60° C.
  • a passivation layer can also be achieved by gas-phase deposition of dielectric materials, such as SiO 2 .
  • diamond-like carbon (DLC), SiC or TiN can be applied. Routine methods are known to a person skilled in the art.
  • a coating with parylene (preferably parylene C) which is a plastic with high barrier effect to aqueous media, primarily as a complete layer, is advantageous.
  • This material can be applied to the substrate as pore-free and transparent polymer film in a vacuum by condensation from the gas phase. A separation of the x-ray marker from the material layer is achieved in this embodiment by a suitable mechanical stimulus, such as ultrasound.
  • the predetermined breaking point is preferably severed by the action of a force, in particular a periodic force, and therefore the region/x-ray marker is separated from the part of the material layer surrounding the region.
  • a force in particular a periodic force
  • ultrasonic waves can be used for this purpose, which are coupled into the predetermined breaking point.
  • the plasma-chemical oxidation can be performed in an electrolyte for example, in that the material layer is contacted with a metal conductor (for example titanium wire) and is immersed in an electrolyte, which for example comprises a mineral acid and ethanol, wherein an electrode acting as cathode made of a preferably rust- and acid-resistant metal (for example a suitable rust- and acid-resistant steel) is arranged in the electrolyte or in an electrolyte container receiving the electrolyte.
  • an x-ray marker surface is oxidised in particular up to a depth of approximately 2 to 4 ⁇ m. Insulating oxide layers can already be arrived from a depth of 0,5 ⁇ m on.
  • This in particular also causes the oxidation of the predetermined breaking point itself, so that this is preferably oxidised through once the plasma-chemical process is complete.
  • a loss of the material cohesion and a breaking-off of the x-ray marker from the connection to the material layer or from the foil or tube composite result.
  • the separated x-ray marker is then captured, for example by means of a (in particular net-like) capturing device made of plastic, which was placed beforehand in the electrolyte or in the container.
  • the x-ray marker is then removed from the electrolyte and rinsed. Once the rinsing process (for example in distilled water) is complete, a surface-passivated x-ray marker free from electrolyte residues is present, which can then be fixed to a medical implant (see below as well) once dried (for example in warm air).
  • the x-ray marker can also remain in the foil/tube connection once the plasma-chemical process is finished. Separation then occurs only with rinsing in distilled water in a container into which ultrasonic waves for example are coupled. Here, it must be ensured that the ultrasonic influence is dosed so that there is no damage caused to the layer.
  • Other mechanical stimuli specified herein can be suitable, equally.
  • This procedure on the one hand advantageously rules out mechanical damage to the x-ray marker surfaces and on the other hand leads to a negligibly small remaining metal fracture area of the predetermined breaking point.
  • This remaining fracture area is advantageously significantly smaller than one that would have been produced by mechanical break-off, for example by bending.
  • the predetermined breaking point is placed inside the x-ray marker. This rules out direct contact with the eyelet.
  • the method advantageously allows a parallelisation of the x-ray marker production.
  • the individual regions can then be treated in the manner described herein simultaneously, such that, at the end of the process, a corresponding multiplicity of x-ray markers is produced (simultaneously).
  • a further aspect of the present invention relates to an x-ray marker which has been produced by the method according to the invention.
  • a further aspect of the present invention also relates to an x-ray marker which has at least one section which is arranged such that a contact face has a breaking point severed in order to produce the x-ray marker or has a breaking point produced by severing at least one predetermined breaking point, which breaking point is arranged in the section of the x-ray marker such that the breaking point lies further inward (i.e. is disposed closer to the centre of the x-ray marker) than two outer edge portions of the region, between which the section lies (see also above).
  • such x-ray marker may be provided with an insulating layer, preferably a layer of at least one oxide or silicate of the material the material layer is formed of
  • the oxide or silicate layer has a thickness of more than 0.5 ⁇ m.
  • the oxide or silicate layer has a thickness in the range of 1 to 8 ⁇ m, and more preferably in the range of 2 to 5 ⁇ m.
  • a further aspect of the present invention also relates to a semifinished product for producing an x-ray marker, in particular an x-ray marker according to the invention, wherein the semifinished product is formed by the material layer, in particular in the form of a metal foil or a tube (see also above), into which at least one region of the material layer forming the x-ray marker to be produced is pre-cut such that said region is connected to the part of the material layer surrounding the region (in particular merely) via at least one web extended along an extension direction, which web the forms a predetermined breaking point.
  • the at least one predetermined breaking point is preferably arranged in an section (formed in particular by the pre-cutting) of the region such that the predetermined breaking point lies further inwardly in the extension direction of the web than two edge portions of the region, between which the section lies.
  • the material layer is preferably formed here such that the web width perpendicularly to the extension direction of the web lies in the range of from 1 ⁇ m to 20 ⁇ m and preferably in the range of from 2 to 10 ⁇ m and in particular in the range of 5 to 7 ⁇ m.
  • the predetermined breaking point is also formed in particular such that in acid medium it corrodes through much more quickly than the other material layer.
  • the herein suggested method for producing x-ray markers for scaffolds is highly advantageously influenced, because the production can be carried out extremely efficient. Not only is it possible that a great number of x-ray markers can be processed simultaneously while still being connected via the web to the material layer after cutting, it is moreover possible to completely passivate the x-ray markers, polish the x-ray markers and disconnect the x-ray markers from the material layer in one step.
  • the x-ray markers In comparison to common procedures where the marker disconnection from a material layer is done by another cutting step, the x-ray markers would still be provided with an open spot exhibiting fresh and open marker material which needs to be insulated in order to avoid local elements which highly influence the performance of the x-ray marker and the scaffold. Hence, it is thereby provided a very elegant production procedure x-ray markers for scaffolds facilitated by the specific embodiments of the marker elements themselves and the semifinished product as suggested herein.
  • the regions can again be connected individually in the above-described manner to the corresponding surrounding part of the material layer, in each case via at least one web.
  • a semifinished product of this type makes it possible advantageously to produce a plurality of x-ray markers in parallel.
  • a further aspect of the present invention lastly relates to a medical implant, in particular in the form of a framework, wherein the medical implant comprises at least one x-ray marker according to the invention, which in particular is arranged in a receptacle (what is known as an eyelet) of the framework.
  • a receptacle of this type can be formed for example on a strut of the framework.
  • the at least one x-ray marker By means of the at least one x-ray marker, it is possible to determine the position of the implanted implant by means of radiography, for example in the body of the patient.
  • the framework is preferably a stent framework, in particular a degradable stent framework, which for example is designed and provided to be implanted into a blood vessel of the patient.
  • the stent framework has a multiplicity of interconnected struts, which form the cells of the stent framework.
  • the stent framework in particular has two ends, which surround an inlet opening and outlet opening of the stent framework, through which, respectively, blood can flow into and out again from an interior of the stent framework surrounded by the stent framework.
  • a receptacle (eyelet) can be provided, which is preferably formed as a through-opening of a strut of the framework or stent framework, wherein an x-ray marker according to the invention is fixed in the receptacle.
  • a receptacle can also be provided which is preferably formed as a through-opening of a strut of the framework or stent framework, wherein an x-ray marker according to the invention can likewise be fixed in the receptacle of the other end.
  • the invention in an advantageous manner, enables the use of solid x-ray markers, the use of which previously with degradable scaffold materials, such as magnesium or magnesium alloys, would have resulted in increased corrosion rates and therefore in a significantly reduced service life.
  • the process of laser cutting a large number of markers from a material layer/foil/tube is very economical in terms of production compared to the production of individual markers, since all measures for individual contacting are spared.
  • the passivation of entire material layer portions/foil/tube portions having pre-cut x-ray markers facilitates the process steps of pickling and passivation by advantages brought about on account of the omission of the individual contacting.
  • the inward predetermined breaking point ensures that there is no metal-metal contact, which promotes local element formation and thus increases the risk of corrosion.
  • the detachment of the x-ray marker from the material layers or foil/tube composite caused by the process of plasma-chemical or wet-chemical oxidation is not accompanied by any mechanical loading of the predetermined breaking point.
  • the remaining metal fracture area still present at the predetermined breaking point is thus minimised advantageously to a few ⁇ m 2 , if there is any such remaining area at all. Even if there was remaining a metal fracture area local elements would not occur due to the inwardly directed position of the area which excludes direct contact between the metal fracture area and the scaffold material.
  • the method according to the invention avoids damage to the passivated surface caused by scratches or the like, particularly in the edge regions of the marker, which are particularly susceptible to the formation of local elements, and cannot be ruled out when the markers are pushed out mechanically.
  • FIG. 1 a shows a perspective view of an x-ray marker according to the invention having a predetermined breaking point
  • FIG. 1 b shows a perspective view of an x-ray marker according to the invention having two predetermined breaking points
  • FIG. 2 a shows a plan view of an x-ray marker according to the invention having a predetermined breaking point
  • FIG. 2 b shows a plan view of an x-ray marker according to the invention having two predetermined breaking points
  • FIG. 3 shows the detail A from FIG. 2 ;
  • FIG. 4 a shows an image recorded by scanning electron microscope (SEM) of the x-ray marker still in the material layer or foil material and connected to the material layer via a web;
  • FIG. 4 b shows an image recorded by light microscope of the x-ray marker still in the material layer or foil material and connected to the material layer via two webs;
  • FIG. 5 shows a detailed view, obtained by scanning electron microscope, of an inwardly offset predetermined breaking point that is still intact
  • FIG. 6 shows burr formation at the laser-cutting edges: SEM image before the pickling process, i.e. before contact of the material layer with a suitable acid;
  • FIG. 7 shows the burr formation at the laser-cutting edges: SEM image after the pickling process
  • FIG. 8 shows an overview of laser-cut x-ray markers in a semifinished product, each marker having an inward predetermined breaking point
  • FIG. 9 shows an eyelet with, stuck therein, an x-ray marker according to the invention having an inward predetermined breaking point (image recorded by light microscope).
  • FIGS. 1 to 3 show an x-ray marker 1 according to the invention which preferably comprises a highly absorbent x-ray marker surface (for example made of tungsten and/or tantalum), which preferably is passivated so that, following assembly in the receptacles (eyelets) 101 ( FIG. 4 ) of a degradable or also non-degradable medical implant 100 (for example a framework, in particular a stent framework), there is no occurrence of accelerated corrosion.
  • a highly absorbent x-ray marker surface for example made of tungsten and/or tantalum
  • a degradable or also non-degradable medical implant 100 for example a framework, in particular a stent framework
  • FIG. 1 a shows a graphical representation of an x-ray marker 1 according to the invention which extends along the longitudinal direction L and comprises a section 21 in which the predetermined breaking point 23 is disposed inwardly.
  • FIG. 1 b an embodiment of the x-ray marker 1 according to the invention which has two mutually opposed sections 23 is shown in the same illustration.
  • FIGS. 2 a and 2 b now show the x-ray markers 1 from FIGS. 1 a and 1 b in a plan view.
  • a region A is marked by a circle and is shown in detail in FIG. 3 .
  • dimensions here in FIGS. 2 a and 2 b are specified in millimetres and standard deviations thereof.
  • FIG. 3 shows a detailed view of the region A from FIGS. 2 a and 2 b .
  • What can be seen is the position of the predetermined breaking point 21 in the section 23 directed inwardly from the outer side of the x-ray marker 1 .
  • the inwardly directed position is visible in particular by the edges 1 a and 1 b arranged further outwardly in the extension direction E compared to the predetermined breaking point 21 .
  • the web 20 provided formerly is indicated in FIG. 3 by dashed lines.
  • FIGS. 4 a and 4 b show microscopic images of the x-ray marker 1 connected to the material layer 2 via one web ( FIG. 4 a ) or two webs ( FIG. 4 b ).
  • the gap 24 here separates the x-ray marker 1 from the surrounding material 22 of the material layer 2 .
  • FIG. 5 an image of the region A of FIGS. 2 a and 2 b recorded by SEM is shown, wherein here the web 20 is still connected to the x-ray marker 1 via the predetermined breaking point 21 .
  • the inwardly directed position of the predetermined breaking point 21 compared with 1 a and 1 b is also clearly visible here.
  • FIG. 6 shows an image of the gap 24 recorded by SEM.
  • the burr 25 can be seen before this is treated with suitable acid.
  • the effects of the treatment with a suitable acid on the gap 24 and the burr 25 are shown in FIG. 7 .
  • the burr 25 has significantly lost roughness and sharp edges, and the treatment with suitable acid results in a material-removing effect.
  • FIG. 8 also shows that the present method is suitable for pre-cutting a multiplicity of x-ray markers 1 into a material layer 2 so as to achieve a high level of automation of the production process. It can be seen that a multiplicity of x-ray markers 1 can be produced simultaneously by the same applied method step.
  • FIG. 9 shows an image recorded by light microscope of an x-ray marker 1 according to the invention which has been introduced into a receptacle 101 (eyelet) of a strut 102 of a framework 100 .
  • a receptacle 101 eyelet
  • any metal-metal contact with the strut 102 is ruled out by the inwardly directed position of the predetermined breaking point.
  • the x-ray marker 1 is preferably produced in that a corresponding region 1 is pre-cut almost fully into a flat material layer 2 , which is preferably a metal foil 2 , for example by means of a laser (for example see FIG. 4 a , 4 b or 8 ).
  • markers 1 In order to prevent a premature breaking-off of the markers 1 from the material layer 2 , these are provided with at least one geometrically inwardly offset predetermined breaking point 21 , as is illustrated for example in FIGS. 1 to 3 and 5 .
  • FIGS. 1 b , 2 b and 4 b an embodiment is shown by way of example in FIGS. 1 b , 2 b and 4 b , in which a second predetermined breaking point opposite the first predetermined breaking point is provided.
  • Said pre-cutting is carried out in particular so that the region 1 of the material layer 2 is connected via at least one web 20 , which is extended along an extension direction E and which forms the (inward) predetermined breaking point 21 , to a part 22 of the material layer 2 surrounding the region 1 , wherein the predetermined breaking point 21 is “inward”, since it is arranged in a section 23 (formed by the pre-cutting) which is formed or arranged at an outer edge of the region 1 so that the predetermined breaking point 21 or the base of the web 20 lies further inwardly in the extension direction E (for example FIGS. 2 a , 2 b and 5 ) of the web 20 (i.e. closer to the centre of the region/x-ray marker 1 ) than two edge portions 1 a , 1 b of the region 1 , between which the section 23 is disposed.
  • the extension direction E for example FIGS. 2 a , 2 b and 5
  • the region 1 or the x-ray marker 1 is formed in an elongate manner and extends along a longitudinal axis L.
  • Said extension direction E of the web 20 runs here primarily perpendicularly to the longitudinal axis L.
  • said edge portions 1 a , 1 b run on either side of the section 23 or web 20 , preferably along or parallel to the longitudinal axis L of the region 1 /x-ray marker 1 .
  • the region 1 or x-ray marker 1 can have an oval or elongate form with rounded corners or semi-circular ends.
  • the web width B of the predetermined breaking point 21 or of the web 20 is for example approximately 8 ⁇ m.
  • the gap 24 (in particular laser cutting gap 24 ), which is produced during the pre-cutting, is for example between 10 and 100 ⁇ m wide.
  • the mechanical strength of the predetermined breaking point 21 is sufficient to attain an adequate transport and storage capability without the marker 1 breaking off prematurely.
  • the film or material layer 2 is immersed in a suitable acid or acid mixture.
  • the composition of this acid mixture is dependent, as described herein, on the material of the x-ray marker 1 .
  • the pickling effect that then occurs results in a chemical levelling or polishing of the very rough burr 25 (see FIGS. 6 and 7 ) produced during the pre-cutting or laser cutting, and in particular results in a small widening of the laser cutting gap 24 .
  • the web width B is reduced in such a step for example from approximately 8 ⁇ m to approximately 3 ⁇ m.
  • the foil/material layer 2 is contacted by way of example with a titanium wire and is immersed in a mixture of an electrolyte containing mineral acid and ethanol.
  • the electrolyte container here has an electrode configured as a cathode and made of a rust- and acid-resistant steel.
  • a plasma-chemical process is performed, which is described by way of example in some examples of the invention detailed further below, wherein, during the course of said process, the x-ray marker surface is oxidised or otherwise passivated, for example to a depth of approximately 2 to 4 ⁇ m.
  • This preferably carried out under plasma-chemical conditions
  • This also causes an oxidation of the predetermined breaking point 21 itself.
  • This is preferably oxidised through once the plasma-chemical process is complete. A corresponding loss of the material cohesion and a breaking-off of the marker 1 from the connection of the foil or the material layer 2 results.
  • the separated marker 1 now falls into a capturing device, which for example is net-like (for example made of a plastic), which was placed beforehand in the electrolyte.
  • the device is then removed from the electrolyte and rinsed preferably a number of times.
  • x-ray markers that are free from electrolyte residues and that are surface-passivated are present, which are then available—after drying (for example in warm air)—for the assembly process.
  • material layers 2 or semifinished products 200 are used, as shown in FIG. 10 .
  • a number of regions 1 /x-ray markers 1 are pre-cut (in the above-described way) into a material layer 2 (metal foil 2 ) so that a number of x-ray markers 1 can be produced in parallel.
  • a finished x-ray marker 1 according to the invention is preferably glued in accordance with FIGS. 6 and 9 into a receptacle (what is known as an eyelet) 101 , which for example is formed as a through-opening 101 in a strut 102 of a medical implant 100 .
  • An implant 100 of this type is preferably a framework 100 , in particular a stent framework 100 , which is preferably degradable.
  • the x-ray marker 1 can of course also be used with non-degradable frameworks/stent frameworks 100 .
  • a framework (scaffold) 100 made of a degradable magnesium alloy has a receptacle (eyelet) at a distal end and at a proximal end, which receptacle is provided for assembly with x-ray markers 1 .
  • the diameters of the oval eyelet 101 are approximately 800 ⁇ m and approximately 350 ⁇ m.
  • Oval undersized solid markers 1 made of tungsten with inward predetermined breaking points 21 are assembled in these eyelets 101 (see FIGS. 1 and 2 ).
  • the thickness of this tungsten marker 1 is in particular identical to the wall thickness of the scaffold 100 , and for example is 100 ⁇ m.
  • the undersize relative to the corresponding eyelet dimensions is in each case 20 to 30 ⁇ m, for example.
  • the tungsten marker 1 has a predetermined breaking point 21 in relation to the rest of the foil 2 (see FIGS. 3 and 5 ) and has therefore been cut out beforehand from a foil 2 by means of a laser light beam (see FIGS. 4 and 5 ).
  • the cutting gap 24 is for example between 10 and 100 ⁇ m.
  • the burr 25 produced during the laser cutting is removed by pickling in a mineral acid, for example an acid mixture having a temperature of 30° C. formed from nitric and hydrochloric acid, over 2 to 5 min (see FIGS. 7 and 8 ). This is followed by a three-stage rinsing process in distilled hot water having a temperature of 80° C.
  • the foil material 2 is plasma-chemically oxidised with the laser-cut x-ray markers 1 in an electrolyte containing sulphuric acid and phosphoric acid.
  • the oxidation of the chemically stable element tungsten is brought about by the locally limited plasma discharges at bath voltages above 180 V.
  • individual plasma discharges scan the tungsten surface systematically.
  • the surface of the marker 1 thus obtains a method-typical porous surface, which consists predominantly of WO 3 , which is electrically non-conductive and is practically insoluble in water.
  • the oxide layer thickness is between 2 and 4 ⁇ m.
  • the original external geometry of the marker 1 is retained and the oxide layer has a high adhesive strength on account of the material bonding to the underlying metal substrate. Since the plasma-chemical oxidation effect is also effective at the predetermined breaking point 21 , which is approximately 3 ⁇ m wide, said predetermined breaking point is oxidised through.
  • the separated marker 1 falls into a net-like capturing device, which was placed previously in the electrolyte. A subsequent pickling effect in the electrolyte does not take place, since the previously plasma-chemically oxidised surface has a sufficiently high corrosion resistance compared to a maximum residence time in the electrolyte of two minutes.
  • the x-ray marker 1 is then removed from the electrolyte and then subjected to a multi-stage rinsing process in hot water at a temperature of 80° C. Once the rinsing process in distilled water is complete, x-ray markers 1 that are free of electrolyte residues and that are surface-passivated are now provided and are then dried in warm air and are available for assembly processes.
  • the assembly process i.e. the connecting of the x-ray marker(s) 1 to the corresponding implant 100 starts with the wetting or immersion of the x-ray marker 1 in a silicone adhesive, for example: NUSIL Med 2.
  • a silicone adhesive for example: NUSIL Med 2.
  • the inner sides of the eyelet are wetted with the aid of a thin plastic needle, which has been immersed previously in the silicone adhesive.
  • the x-ray marker 1 is then placed in the eyelet 101 using tweezers or another suitable handling device. Another option is to push the x-ray marker directly from the material layer into the receptacle.
  • the silicone adhesive is then cured in a hot-air oven at 150° C. over a period of time of 15 min.
  • the finished, assembled x-ray marker 1 is illustrated in FIG. 9 .
  • the scaffold 100 is provided with an x-ray marker 1 made of tantalum, which has a microporous surface made of tantalum oxide, produced by means of plasma-chemical oxidation.
  • the scaffold 100 made of a degradable magnesium alloy again has an eyelet 101 at the distal end and at the proximal end, which eyelets are provided for assembly with x-ray markers 1 .
  • the diameters of the corresponding oval eyelet 101 are approximately 800 ⁇ m and approximately 350 ⁇ m.
  • Oval undersized solid markers 1 made of tantalum with inward predetermined breaking points 21 are assembled in these eyelets 101 (see FIGS. 1 and 2 ).
  • the thickness of this tantalum marker 1 is identical to the wall thickness of the scaffold 100 and for example is 100 ⁇ m.
  • the undersize relative to the corresponding eyelet dimensions is in each case 20 to 30 ⁇ m.
  • the tantalum marker 1 has a predetermined breaking point 21 in relation to the rest of the foil 2 (see FIGS. 3 and 5 ) and has therefore been cut out beforehand from a foil 2 by means of a laser light beam (see FIGS. 4 and 5 ).
  • the cutting gap 24 is between 10 and 100 ⁇ m in this case as well.
  • the burr 25 produced during the laser cutting is removed by pickling in a mixture formed from nitric acid and hydrofluoric acid at room temperature, over 1 to 3 min. This is followed by a three-stage rinsing process in distilled hot water having a temperature of 80° C.
  • the foil material 2 is plasma-chemically oxidised with the laser-cut x-ray markers 1 in an electrolyte containing phosphoric acid.
  • the oxidation of the chemically stable element tantalum is brought about by the locally limited plasma discharges at bath voltages above 180 V.
  • individual plasma discharges scan the tantalum surface systematically.
  • the surface of the marker 1 thus obtains a method-typical porous surface, which consists predominantly of Ta 2 O 5 and Ta phosphates, which are electrically non-conductive.
  • the oxide layer thickness is between 0.5 and 4 ⁇ m.
  • the original external geometry of the marker 1 is retained and the oxide layer has a high adhesive strength on account of the material bonding to the underlying metal substrate. Since the plasma-chemical oxidation effect is also effective at the predetermined breaking point 21 , which is approximately 3 ⁇ m wide, said predetermined breaking point is oxidised through.
  • the separated marker 1 falls into a net-like capturing device, which was placed previously in the electrolyte. A subsequent pickling effect in the electrolyte does not take place, since the previously plasma-chemically oxidised surface has a sufficiently high corrosion resistance compared to a maximum residence time in the electrolyte of a few minutes.
  • the x-ray marker 1 is then removed from the electrolyte and then subjected to a multi-stage rinsing process in hot water at a temperature of 80° C. Once the rinsing process in distilled water is complete, x-ray markers 1 that are free of electrolyte residues and that are surface-passivated are now provided and are then dried in warm air and are available for assembly processes.
  • the assembly process starts again with the wetting or immersion of the x-ray marker 1 in a silicone adhesive, for example NUSIL Med 2.
  • a silicone adhesive for example NUSIL Med 2.
  • the inner sides of the eyelet 101 are wetted with the aid of a thin plastic needle, which has been immersed previously in the silicone adhesive.
  • the x-ray marker 1 is then placed in the eyelet 101 using tweezers or another suitable handling device.
  • the silicone adhesive is then cured in a hot-air oven at 150° C. over a period of time of 15 min.
  • the finished, assembled x-ray marker 1 is constructed as illustrated in FIG. 9 .
  • a scaffold 100 made of nitinol is provided with an x-ray marker 1 made of gold having a predetermined breaking point 21 approximately 5 ⁇ m wide.
  • the scaffold 100 made of a nickel-titanium alloy nitinol has an eyelet 101 at the distal end and at the proximal end, which eyelet is provided for assembly with an x-ray marker 1 .
  • the diameters of the corresponding oval eyelet 101 are approximately 800 ⁇ m and approximately 350 ⁇ m.
  • Oval undersized solid markers 1 made of gold with inward predetermined breaking points 21 are assembled in these eyelets 101 (see FIGS. 1 and 2 ).
  • the thickness of this gold marker 1 is identical to the wall thickness of the scaffold 100 and for example is 100 ⁇ m.
  • the undersize relative to the corresponding eyelet dimensions is in each case 20 to 30 ⁇ m.
  • the gold marker 1 has a predetermined breaking point 21 in relation to the rest of the foil 2 (see FIGS. 3 and 5 ) and has therefore been cut out beforehand from a foil 2 by means of a laser light beam (see FIGS. 4 and 5 ).
  • the cutting gap 24 is between 50 and 100 ⁇ m in this case as well.
  • the burr 25 produced during the laser cutting is removed by pickling diluted aqua regia (1 part HNO 3 +3 parts HCl). After a treatment time of approximately 1 min., the foil 2 is removed from the pickling bath and is freed of adhering pickling residues in a three-stage rinsing process in distilled hot water having a temperature of 80° C.
  • the film 2 is then immersed in an aqueous sodium-silicate mixture or lithium-silicate mixture (waterglass).
  • This mixture has a temperature of approximately 50° C.
  • an electrically insulating layer formed of silicates and approximately 2 to 5 ⁇ m thick is deposited on the gold surfaces, which for example can have the following empirical formulas, such as Na 2 O 7 Si 3 , Na 2 O 3 Si, Na 2 O 5 Si 2 or Na 4 O 4 Si or in the case of the lithium silicate Li 2 O, SiO 2 or Li 2 SiO 3 .
  • the following two method steps can then be performed:
  • the foil material 2 with the laser-cut x-ray markers 1 and the dielectric layer now provided is brought into a plastic container filled with distilled water, which container is exposed to ultrasound in the frequency range between 25 and 50 kHz.
  • the x-ray markers 1 are set in mechanical vibration, meaning that they break off at the predetermined breaking point, break off from the connection to the foil, and drop into the vessel, without the surface being damaged.
  • the water is then removed from the plastics container and the separated x-ray markers are dried in air.
  • the foil material 2 with the laser-cut x-ray markers 1 and the dielectric layer now provided is brought into a slightly alkaline, diluted NaOH solution.
  • the pH value is between 8 and 9.
  • the plastic container with the x-ray markers 1 now coated with sodium silicate is brought into an ultrasonic bath.
  • ultrasound in the frequency range between 25 and 50 kHz, the foil material is set in slight vibration, which causes the individual markers 1 to break off from the connection to the foil 2 at the predetermined breaking point 21 .
  • the separated markers 1 can then be removed from the container and dried in air.
  • the assembly process starts again with the wetting or immersion of the x-ray marker 1 in a silicone adhesive, for example NUSIL Med 2.
  • a silicone adhesive for example NUSIL Med 2.
  • the inner sides of the eyelet 101 are wetted with the aid of a thin plastic needle, which has been immersed previously in the silicone adhesive.
  • the x-ray marker 1 is then placed in the eyelet 101 using tweezers or another suitable handling device.
  • the silicone adhesive is then cured in a hot-air oven at 150° C. over a period of time of 15 min.
  • the finished, assembled x-ray marker 1 is again constructed as illustrated in FIG. 9 .

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  • Health & Medical Sciences (AREA)
  • Engineering & Computer Science (AREA)
  • Biomedical Technology (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Animal Behavior & Ethology (AREA)
  • Oral & Maxillofacial Surgery (AREA)
  • Veterinary Medicine (AREA)
  • Heart & Thoracic Surgery (AREA)
  • Public Health (AREA)
  • General Health & Medical Sciences (AREA)
  • Surgery (AREA)
  • Cardiology (AREA)
  • Transplantation (AREA)
  • Vascular Medicine (AREA)
  • Molecular Biology (AREA)
  • Medical Informatics (AREA)
  • Pathology (AREA)
  • Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
  • Mechanical Engineering (AREA)
  • Media Introduction/Drainage Providing Device (AREA)
  • Materials For Medical Uses (AREA)
  • Prostheses (AREA)
  • Analysing Materials By The Use Of Radiation (AREA)
US16/475,544 2017-01-11 2018-01-08 X-ray markers for scaffolds Active 2040-08-05 US11951024B2 (en)

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EP17150973.0A EP3348239A1 (en) 2017-01-11 2017-01-11 X-ray markers for scaffolds
EP17150973.0 2017-01-11
EP17150973 2017-01-11
PCT/EP2018/050345 WO2018130489A1 (en) 2017-01-11 2018-01-08 X-ray markers for scaffolds

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EP3560452B1 (de) 2018-04-24 2024-05-15 Biotronik Ag Markerelement und verfahren zu dessen herstellung
DE102018113810A1 (de) * 2018-06-11 2019-12-12 Cortronik GmbH Funktionsmarkerelement und Verfahren zu dessen Herstellung
US11266481B2 (en) * 2018-10-12 2022-03-08 Hologic, Inc. Tissue localization marker with D-shaped cross-section

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US20190336310A1 (en) 2019-11-07
AU2018207805A1 (en) 2019-07-18
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AU2018207805B2 (en) 2023-12-14
EP3568111B1 (en) 2021-03-03
CN110121316B (zh) 2022-02-18
JP2020503935A (ja) 2020-02-06
EP3348239A1 (en) 2018-07-18
SG11201906215VA (en) 2019-08-27
EP3568111A1 (en) 2019-11-20
JP7093356B2 (ja) 2022-06-29
ES2874334T3 (es) 2021-11-04

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